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Individual
JORDAN SESTAK BRUCE
Active
Individual
JORDAN SESTAK BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125066620
IL
208100000X
Physical Medicine & Rehabilitation Physician
036.150367
IL
208100000X
Physical Medicine & Rehabilitation Physician
217843
NC
Other
Enumeration date
06/24/2015
Last updated
04/06/2022
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